一起大肠埃希菌感染引起食源性疾病暴发事件的调查  

An investigation on an outbreak of foodborne disease caused by Escherichia coli infection

作　　者：吴建美 刘婷婷 宋壮志 李伟 WU Jian-mei;LIU Ting-ting;SONG Zhuang-zhi;LI Wei(Inner Mongolia Autonomous Region Center for Disease Control and Prevention,Inner Mongolia 010080,China)

机构地区：[1]内蒙古自治区综合疾病预防控制中心,内蒙古010080

出　　处：《中国卫生检验杂志》2023年第15期1912-1914,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的核实食源性疾病暴发事件的规模,查明病原及发生原因,提出针对性的预防控制措施和建议,防止类似事件发生。方法制定病例定义、搜索病例、进行流行病学及食品卫生学调查,采集可疑食物样本、用具及环境涂抹样本、病例肛拭子及厨师肛拭子进行实验室检测。结果本次病例主要临床症状为腹泻(95.2%)、腹痛(90.3%),部分病例伴发热(29.0%)。流调显示,所有病例发病前48 h内均食用外卖食品。食品卫生学调查发现外卖中有蔬菜未充分加热,且储存生熟未分,厨师做菜时徒手操作。实验室结果显示,4例病例和1名外卖厨师肛拭子、圆葱条中均检出肠侵袭性大肠埃希菌阳性。结论此次事件为一起肠侵袭性大肠埃希菌感染引起的学生食物中毒事件,外卖中未煮熟蔬菜及厨师为可能感染源。建议市场监督管理部门加大对餐饮及食品生产经营单位监督检查力度,严格执行食品留样和生熟分开等制度,加强对食品从业人员卫生安全知识相关培训。Objective This paper aims to investigate an outbreak of foodborne disease caused by Escherichia coli,identify pathogenic factors,transmission routes and sources,and put forward targeted prevention and control measures and suggestions to prevent similar incidents.Methods The authors develop case definitions,search for cases and conduct epidemiological and food hygiene investigations,collect suspected food samples,utensils and environmental smear samples,anal swabs of cases and chef anal swabs for laboratory testing.Results The main clinical symptoms were diarrhea(95.2%),abdominal pain(90.3%),and fever(29.0%)in some cases.The results showed that all cases consumed takeaway food within 48 hours before the onset of disease.Food hygiene investigation found that there were vegetables in takeout that were not sufficiently heated,and were stored raw and cooked without being divided,and the chef cooked with his bare hands.Laboratory results showed invasive Escherichia coli was detected in onion strips and the anal swab of 4 cases and 1 cook for takeout food.Conclusion This is a case of food poisoning caused by invasive Escherichia coli,with undercooked vegetables and cooks as possible sources of infection.It is suggested that the market supervision and administration departments increase the supervision and inspection of catering and food production and operation units,strictly implement the system of retaining food samples and separating raw and cooked food,and strengthen the relevant training of health and safety knowledge for food practitioners.

关 键 词：食源性疾病 侵袭性大肠埃希菌 学生 外卖小吃 

分 类 号：R155.5[医药卫生—营养与食品卫生学]